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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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I HATE OXFORD***UPDATE***
Those SOB's denied me my IUI this cycle. They said thY since I have several failed attempts they don't think it will help me. Who the F are they? Did the fact that I got pregnant my first IUI not count??? I am so pissed. I have my appt in the morning and now I am going to have to pay OOP. Grrrrr I want to cry!
***UPDATE****
Went in today and told them I got denied. They will thankfully eat the cost of this cycle. Thank god since that would be over $1550!! They told me to call to appeal and tell them that NYS mandates that IUIs be covered unlimited until your 45th birthday!! Did anyone else know that?? How can they pull this crap?
Oh and it gets better. I was told I am.not getting the grant. The list is closes till Oct. Guess I will be footing the IVF bill OOP next cycle  today just sucks!!!
Message edited 6/19/2013 10:12:35 AM.
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Posted 6/18/13 8:32 PM  |
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Long Island Weddings
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: I HATE OXFORD
Oh no!!! I hate them too. Any way you can try to fight it? Speak to someone in upper management or something? I hate that they decide what care we receive. It's Bull$hit
Message edited 6/18/2013 8:41:00 PM.
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| Posted 6/18/13 8:40 PM |
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PennyCat
Just call me mommy :)
Member since 7/08 19084 total posts
Name:
Jib
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Re: I HATE OXFORD
ugh that's crazy! Did they say they will cover IVF in that case?   I bet your dr can fight it!
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| Posted 6/18/13 8:50 PM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD
Posted by PennyCat
ugh that's crazy! Did they say they will cover IVF in that case? I bet your dr can fight it!
Nope. IVF isn't covered what so ever
We pay OOP unless we are lucky enough to get the grant
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| Posted 6/18/13 8:56 PM |
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Lillies
Grateful for my babies!
Member since 2/12 4571 total posts
Name:
<3
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Re: I HATE OXFORD
Is there a limit to how many IUI's they will cover?
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| Posted 6/18/13 9:33 PM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD
Four medicated. Then they evaluate on a case by case basis. They suck
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| Posted 6/18/13 10:28 PM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: I HATE OXFORD
Posted by Lala08
Posted by PennyCat
ugh that's crazy! Did they say they will cover IVF in that case? I bet your dr can fight it!
Nope. IVF isn't covered what so ever
We pay OOP unless we are lucky enough to get the grant
At all ? That's crazy; they should give you at least 1 IVF if they are going to say no more IUIs.
So sorry you are going through this.
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| Posted 6/18/13 10:38 PM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD
Posted by TyReseGreen
Posted by Lala08
Posted by PennyCat
ugh that's crazy! Did they say they will cover IVF in that case? I bet your dr can fight it!
Nope. IVF isn't covered what so ever
We pay OOP unless we are lucky enough to get the grant
At all ? That's crazy; they should give you at least 1 IVF if they are going to say no more IUIs.
So sorry you are going through this.
Yeah.that would be nice. Can't wait to.find out how much I.owe for this cycle.
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| Posted 6/19/13 6:21 AM |
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JWG421
Our miracle is here
Member since 12/12 2507 total posts
Name:
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Re: I HATE OXFORD
so sorry
is there any way that your RE can show them charts or something showing you can get preg?
This whole thing blows- we have 6 IUI covered and then onto IVF which is not cvd
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| Posted 6/19/13 6:49 AM |
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MrsM429
Mama x2 <3
Member since 12/10 4946 total posts
Name:
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Re: I HATE OXFORD
I'm so sorry to hear- insurance companies SUCK! Is there anything your doctor can do? Maybe a recommendation to the claims department? I hope this works out for you 
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| Posted 6/19/13 7:39 AM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
Update at top
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| Posted 6/19/13 10:12 AM |
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WantBabyNbr2
LIF Adolescent
Member since 8/12 676 total posts
Name:
Amy
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Re: I HATE OXFORD***UPDATE***
That was really nice of them to give you a free cycle! I know not having coverage sucks, b/c i have zero coverage for IF so i have to pay $1200 per cycle for monitoring plus drugs... so at least you got some cycles covered by insurance.
Hopefully this cycle will be it for you and you won't have to worry about IVF!!
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| Posted 6/19/13 10:43 AM |
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JWG421
Our miracle is here
Member since 12/12 2507 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
GOod luck w your insurnace for IUI
thatis good news
Stinks about the IVF and the closed Grant. MY RE doesnt participate in it either so this Blows
Good luck, hopefully you wont need to go further
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| Posted 6/19/13 10:43 AM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
Yes I definitely can't complain too much. I.am lucky to have had the past 5cycles covered. Just makes me mad that there insurance companies decide our IF fate.
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| Posted 6/19/13 10:46 AM |
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MrsGoldie
<3 Miracles can happen <3
Member since 9/12 1700 total posts
Name:
R
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Re: I HATE OXFORD***UPDATE***
I'm so sorry! I CANNOT EVEN BELIEVE THEY DENIED YOU!!!!! WTH?!?!?! Who are they to say no it's not going to work so too bad! If they would just pay for the IVF they could save themselves a lot of money instead of being mandated to pay for unlimited IUI til we are 45. (which i was not aware of...good to know!) Awesome that they are waving the fee for this cycle!!!!
Stinks about the grant too. I called Mineola in Nov and there were already like 50 people on the list. We will be OOP too if this cycle doesn't work. 
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| Posted 6/19/13 11:59 AM |
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: I HATE OXFORD***UPDATE***
Really????? Unlimited to 45???
I wonder who you can call or where you can get the information for that... I'd like to gather the info and then call Oxford with it. If I just call and say the drs office said etc etc etc, that isn't enough.
Hmmmmmmmmmm
Let the research begin!
I'll let you know if I get anywhere with this
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| Posted 6/19/13 3:04 PM |
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JDubs
different, not less
Member since 7/09 13160 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
ugh, so sorry you are going through this. 
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| Posted 6/19/13 4:08 PM |
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babydreams21
LIF Adult
Member since 12/12 3656 total posts
Name:
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I HATE OXFORD***UPDATE***
So sorry. Hopefully you can fight for it and they will see IUI can work for you.
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| Posted 6/19/13 6:26 PM |
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: I HATE OXFORD***UPDATE***
So far I have found NOTHING lol
Nothing about Mandatory IUIs. I wonder if the Dr. has any info on it?
Hmmmmm
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| Posted 6/20/13 7:36 AM |
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MrsM429
Mama x2 <3
Member since 12/10 4946 total posts
Name:
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I HATE OXFORD***UPDATE***
The only thing I've found is that NYS is a state that mandates insurance companies to provide infertility testing to all men and women- but there are loopholes. If your health insurance is through your employer, and the policy is is self insured (which most are), then they do not have to follow the state guild lines. If they are fully insured, then they MUST provide you with fertility testing.
Also, if your employer is located out of state (let's say you work for a branch of a corporate company based out of state), then they do not have to cover any testing.
Also, if your company is based in another state, and that state offers any other type of fertility treatment (like IUIs), but you do not live in that state, then you can not reap that benefit.
I did so much research through the resolve website trying to find out if anything was covered since we pay out of pocket for everything, but we were shit out of luck. Hopefully the testing part can help out some women on here though.
ETA: here's the link explaining in detail what is covered by law
Resolve.org
Message edited 6/20/2013 9:01:45 AM.
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| Posted 6/20/13 8:58 AM |
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Lala08
2 Princesses coming soon!
Member since 12/12 1539 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
Posted by MrsM429
The only thing I've found is that NYS is a state that mandates insurance companies to provide infertility testing to all men and women- but there are loopholes. If your health insurance is through your employer, and the policy is is self insured (which most are), then they do not have to follow the state guild lines. If they are fully insured, then they MUST provide you with fertility testing.
Also, if your employer is located out of state (let's say you work for a branch of a corporate company based out of state), then they do not have to cover any testing.
Also, if your company is based in another state, and that state offers any other type of fertility treatment (like IUIs), but you do not live in that state, then you can not reap that benefit.
I did so much research through the resolve website trying to find out if anything was covered since we pay out of pocket for everything, but we were shit out of luck. Hopefully the testing part can help out some women on here though.
ETA: here's the link explaining in detail what is covered by law
Resolve.org
Thanks for investigating! How do you find out if your company is self insured?
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| Posted 6/20/13 9:11 AM |
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GoodThoughts
Dreams do come true
Member since 2/12 2259 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
There are tons of exemptions to the NYS "mandate." I learned that during my IVF last year. I'm not telling anyone not to pursue things with insurance companies, but be aware that many exemptions exist for the insurance companies.
ETA: I didn't notice the above, informative post when I posted this. She explained the loopholes well.
Message edited 6/20/2013 9:48:49 AM.
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| Posted 6/20/13 9:45 AM |
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MrsM429
Mama x2 <3
Member since 12/10 4946 total posts
Name:
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Re: I HATE OXFORD***UPDATE***
Posted by Lala08
Posted by MrsM429
The only thing I've found is that NYS is a state that mandates insurance companies to provide infertility testing to all men and women- but there are loopholes. If your health insurance is through your employer, and the policy is is self insured (which most are), then they do not have to follow the state guild lines. If they are fully insured, then they MUST provide you with fertility testing.
Also, if your employer is located out of state (let's say you work for a branch of a corporate company based out of state), then they do not have to cover any testing.
Also, if your company is based in another state, and that state offers any other type of fertility treatment (like IUIs), but you do not live in that state, then you can not reap that benefit.
I did so much research through the resolve website trying to find out if anything was covered since we pay out of pocket for everything, but we were shit out of luck. Hopefully the testing part can help out some women on here though.
ETA: here's the link explaining in detail what is covered by law
Resolve.org
Thanks for investigating! How do you find out if your company is self insured?
No problem- hopefully this information can help someone out in a positive way.
I had to bite the bullet and email the benefits administrator of my DH's company in order to find out. DH works for a nation wide corporation, so it took a while to find out who I had to direct the email to, but I was told that they are a self insured (meaning his company pays a portion of our policy and pays all if the claims directly. We pay 1/3 and his company pays the remaining 2/3 of each policy), and there isn't a strong demand for an infertility rider on the policy, so "it's in the best interest of the company to not provided that extra rider". Our insurance company also confirmed it.
Message edited 6/20/2013 3:13:10 PM.
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| Posted 6/20/13 3:07 PM |
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